Asymptomatic Fibroadenoma of the Breast in Pediatric Patients
When a fibroadenoma of the breast is asymptomatic and imaging features are characteristic, the clinical question is whether active intervention is necessary — or whether a structured, non-operative approach is appropriate. This is particularly relevant in the pediatric population and in selected adults.
Clinical scenario
Pediatric patient with an asymptomatic fibroadenoma of the breast, or an adult with a biopsy-proven fibroadenoma smaller than 2 cm, without symptoms requiring immediate intervention.
Approach
Current evidence supports a non-operative strategy centered on clinical surveillance and serial breast imaging — the complete structured protocol is available in the full regimen.
References
DOI: 10.21037/abs-20-100
- Asymptomatic FA management: observation
- Observation alone is reasonable in pediatric FA that are asymptomatic.
- In adult patients, the American Society of Breast Surgeons Choosing Wisely® campaign recommends against routinely excising biopsy-proven FA that are <2 cm.
- If US shows imaging characteristics classic for FA, serial US every 6 months for 2 years and observation.
- The American College of Radiology Appropriateness Criteria® for palpable breast masses even states that short term imaging follow-up (such as every 6 months for 2 years) is a reasonable alternative to biopsy for solid masses with probably benign features suggesting FA.
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